A55-year old man was brought to the emergency with severe multiple injuries in a

Question

A55-year old man was brought to the emergency with severe multiple injuries in a road traffic accident and crush injuries, fractures of the legs and scalp lacerations. He was conscious and breathing spontaneously. PR-130/min, BP-60/40 mm Hg. Laboratory results were as follows: Serum Chemistry sodium 142 mmol/L potassium 7.9 mmol/L chloride 110 mmol/L BUN 40 mg/d Case 6 Questions (5 marks): List all the abnormal results, indicating if they are increased, decreased, critically high, or critically low (1 mark 1. 2. What is the basis of the change(s) in the resuls) (1 mark)? What other chemistry tests should be ordered for this patient AND justify your choices (3 marks)? 3.

Explanation / Answer

Question: 1

Answer:

Abnormal values:

Potassium 7.9 - critically high (normal range 3.5-5.1 mEq/L

Bun 40 - Increased 8 to 24 mg/dl)

Chloride 110- marginally increased

Question: 2

Answer:

Basis of changes: normal reference range

Potassium: 3.5-5.1 mEq/L

Bun (Blood Urea Nitrogen): 8 to 24 mg/dl

Creatinine: 0.6 to 1.2 mg/dl

Chloride: 96 and 106 mEq/L

Sodium: 135 to 145 mEq/L

Question: 3

Answer:

Other chemistry should include:

Complete blood count (CBC)

Justification:

Member showing the manifestation of hypotension and leading to acute kidney injury secondary to blood loss.

CBC lab test consist of Hemoglobin and packed cell volume which will ultimately represents the member blood count status to decide about further management to replace the blood loss by blood transfusion.

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